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2型糖尿病患者系统化健康教育模式的效果

Effectiveness of Systematic Health Education Model for Type 2 Diabetes Patients.

作者信息

Zhang Yongwen, Chu Lanfang

机构信息

Department of Endocrinology, Nanjing Integrated Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China.

Department of Integrated Traditional Chinese and Western Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing 210012, China.

出版信息

Int J Endocrinol. 2018 Jul 25;2018:6530607. doi: 10.1155/2018/6530607. eCollection 2018.

Abstract

BACKGROUND

Health education is considered to be essential in the overall care of patients with type 2 diabetes mellitus (T2DM); systematic health education integrates individual education not only during hospitalization but also extended care outside of a hospital. To test effectiveness of the systematic health education model for T2DM, we conducted a randomized study with a control group among patients with T2DM living in Nanjing, China.

METHODS

998 eligible patients completed the enrollment and were randomized to systematic health education model and conventional model groups (498 and 500 patients, resp.). The systematic health education model was based on the following aspects: image education, visitation of the exhibition hall, dissemination of educational materials, individualized medical nutrition therapy and exercise programs, WeChat group and regular health lectures, evaluation of complications, lifestyle modification, systematic treatment scheme, self-monitoring of glycemic control, monthly evaluation of the therapeutic effect, proposed improvement measures, and individualized follow-up scheme. The main outcome measures were glycated hemoglobin A1c (HbA1c), blood pressure, body mass index (BMI), and lipids during the 2-year follow-up.

RESULTS

The systematic health education model led to a favorable variation in HbA1c, LDL cholesterol, and systolic blood pressure (SBP) ( < 0.05). After adjusted analysis, the HbA1c decreased by 0.67% ( < 0.01) in the systematic health education model, SBP decreased by 10.83 mmHg ( < 0.01), and the level of diastolic blood pressure (DBP), HDL cholesterol, and total cholesterol decreased slightly and was not significant. The BMI did not change significantly during the study in either of the two groups.

CONCLUSIONS

The systematic health education model is a useful method in the treatment of T2DM because it contributes to decrease in HbA1c, LDL cholesterol, and SBP levels, as well as helps in increasing the compliance with the control criteria, except for DBP and BMI.

摘要

背景

健康教育被认为是2型糖尿病(T2DM)患者整体护理的重要组成部分;系统健康教育不仅整合了住院期间的个体教育,还包括院外的延伸护理。为了检验T2DM系统健康教育模式的有效性,我们在中国南京的T2DM患者中进行了一项设有对照组的随机研究。

方法

998名符合条件的患者完成入组并被随机分为系统健康教育模式组和传统模式组(分别为498例和500例患者)。系统健康教育模式基于以下几个方面:形象教育、参观展厅、发放教育材料、个体化医学营养治疗和运动方案、微信群及定期健康讲座、并发症评估、生活方式改变、系统治疗方案、血糖控制自我监测、每月治疗效果评估、提出改进措施以及个体化随访方案。主要观察指标为2年随访期间的糖化血红蛋白A1c(HbA1c)、血压、体重指数(BMI)和血脂。

结果

系统健康教育模式使HbA1c、低密度脂蛋白胆固醇和收缩压(SBP)出现了有利变化(P<0.05)。经校正分析,系统健康教育模式组的HbA1c下降了0.67%(P<0.01),SBP下降了10.83 mmHg(P<0.01),舒张压(DBP)、高密度脂蛋白胆固醇和总胆固醇水平略有下降但无统计学意义。两组研究期间BMI均无显著变化。

结论

系统健康教育模式是治疗T2DM的一种有效方法,因为它有助于降低HbA1c、低密度脂蛋白胆固醇和SBP水平,除DBP和BMI外,还有助于提高对控制标准的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/406e/6083492/03c6392fcfda/IJE2018-6530607.001.jpg

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